Efeito da oxigenação hiperbárica e da n-acetilcisteína na viabilidade de retalhos cutâneos randômicos em ratos / Effects of hyperbaric oxygen and n-acetyilcysteine on survival of random flaps in rats.

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

Objective: To investigate the effects of hyperbaric oxygen (HBO) and N-acetylcysteine (NAC) alone or in association on the viability of skin flaps in rats. Methods: 32 male Wistar rats were randomized in: GS (sham/n=8), GNAC (Nacetylcysteine/ n=8), GHBO (hyperbaric oxygen/n=8) and GNH (NAC+OHB/n= 8). A skin flap measuring cranial base (2x8cm) was performed (McFarlane) and brought a polyethylene film between the skin flap and its surgical bed prior to closure with interrupted polyamide sutures. For seven days the animals received injections of saline intraperitoneally (GS) and NAC at a dose of 300mg/kg (GNAC). HBO was performed for periods of two hours with 2.4 ATA (GOHB) for seven days and the association of NAC and HBO was carried out in group GNH. On the eighth day the dorsum of the animal was photographed and collected biopsy specimen of skin from the flap at thirds proximal, middle and distal flap. The areas of necrosis were evaluated (photos processed by the Image-Lab), assessment of apoptosis (cleaved caspase 3) and angiogenesis (VEGF). The data obtained were statistically analyzed by ANOVA and Bonferroni (p <0.05). Results: The mean areas of necrosis (mm2) were: GS 18.3%, GNAC 24.3%, GOHB 12.6% and GNH 14.9%. The expression of VEGF in the epidermis, dermis, submuscular tissue and vessels was not significant in the different treatment groups. The presence of cells undergoing apoptosis was significantly lower in the middle third of all treated groups compared to sham group, but significantly lower in the group treated with HBO alone or in combination with NAC. Conclusion: HBO is associated with reduced expression of apoptosis and reduced area of necrosis of skin flap. The NAC is not associated with lower expression of apoptosis and alone had the worst results in this experiment. The association of the two procedures did not produce potentiating of the favorable results of the use of both separately. The findings suggest that the diffusion of oxygen through the interstitial space was the determining factor of more favorable results of HBO.

ASSUNTO(S)

radicais livres ratos retalhos cirúrgicos oxigenação hiperbárica n-acetilcisteína antioxidantes vegf caspase cirurgia experimental

ACESSO AO ARTIGO

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